PeakRN

PeakRN

Adult and pediatric emergency and critical care

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All Content by PeakRN

  1. Torn between jobs

    PeakRN replied to Vmurill1's topic in General Nursing

    Watch out for any PRN gig that promises a full schedule, if they don't have a need you'll be the first one well staffed and you won't have any

  2. Bringing in the Boys: How to Attract More Male Nurses

    PeakRN replied to Melissa Mills's topic in General Nursing

    This kind of stuff isn't even an option for me. 12 year old girl complaining of chest pain gets an EKG. If 10 year of girl needs a foley, you won't be able to get the doc to do it. 15 year old with a...

  3. Bringing in the Boys: How to Attract More Male Nurses

    PeakRN replied to Melissa Mills's topic in General Nursing

    If you want more men in nursing remove the misandry from the nursing schools. I personally caught a lot of prejudiced for being a male and having started in fire/ems; multiple instructors told me that...

  4. Icu nurse in USA

    PeakRN replied to Steffany87's topic in Critical Care

    Staffing ratios depend on the patient. For example a ECMO patient will have at least two dedicated nurses, one to sit pump and one to care for the patient, but may have a third if they are a fresh...

  5. Number of Lymph Nodes Removed?

    PeakRN replied to DowntheRiver's topic in General Nursing

    We don't have a formal policy but generally we don't worry about seven or less, eight to thirteen are considered moderate risk, and more than thirteen are considered higher risk. The risk of starting...

  6. Inpatient Boarders?

    PeakRN replied to EDnurseNY's topic in Emergency

    With very rare exception we do not hold patients in the ED, we know that prolonged time in the ED results in poorer outcomes for patients. If we cannot admit a patient upstairs then we will transfer...

  7. Apnea

    PeakRN replied to SnickerDoodle_RN's topic in NICU, Neonatal

    What you are describing sounds more like periodic breathing, which can be very normal for newborns. Like adventure_rn suggested I would be far more concerned about cyanosis, bradies, or desats than...

  8. Any L1 Trauma Nurses Out There

    PeakRN replied to ctsurgeryscrubrn's topic in Critical Care

    I used to work in a level I peds trauma center. Most of our trauma were transfers and field trauma were very rare. Since there are so many people who respond to the trauma alerts each participant gets...

  9. Feeling like a failure in ER nursing

    PeakRN replied to ERnurseH's topic in Emergency

    This is specifically for the plastic salem sumps but rather than warming up the tube in hot water you just stretch it out. This makes removes the curves from the packaging and makes it more pliable...

  10. How do you document an axillary temp

    PeakRN replied to debtor11's topic in General Nursing

    We don't use axillary temps due to their inaccuracy, there are many better ways to take temps on patients of all ages. You should always be documenting actual

  11. Symptomatic vs Unstable..huh?

    PeakRN replied to ISRN's topic in General Nursing

    Patients can also be unstable without symptoms. I recently had a very athletic patient who went into sustained v-tach with a systolic of 70 who denied any symptoms and we had a full conversation about...

  12. Getting into the Emergency department

    PeakRN replied to remotefuse's topic in General Nursing

    How long orientation lasts depends on the background of our new hires, but we go up to 5 months for some nurses. At a minimum our ED nurses need to have ACLS, PALS, NIHSS, all of our in house...

  13. Anesthesia

    PeakRN replied to nursingsprettycool17's topic in Student Registered Nurse Anesthetist

    Anesthesia assistants typically have a much lower scope of practice and less independence than CRNAs. Like all advanced practice nurses the idea of CRNAs is that with additional graduate training on...

  14. Career Changing

    PeakRN replied to TwinDaddy's topic in Men in Nursing

    If you want to be a nurse go for it. I doubt that you'd be making less as a nurse, especially if you pick up occasional extra shifts or work nights/weekends. Nursing school does take quite a bit of...

  15. Following the footsteps of my wife

    PeakRN replied to CMooreFNP2Be's topic in Men in Nursing

    I don't believe that anyone should be going to nursing school without wanting to be a nurse. Advanced practice nurses are just that, they are still nurses but with medical education and practice. They...

  16. AMBU bag VS Neopuff

    PeakRN replied to K.Alva's topic in NICU, Neonatal

    I think some of it is based on preference. I feel like I can better control PIP, PEEP, I/E, and just have a better feel with a flow inflating bag than the neopuff or jet. I know nurses that prefer the...

  17. LPNs in the ER

    PeakRN replied to amandab13's topic in Emergency

    LPNs can start IVs and give piggy back meds or infusions but cannot give high risk IV medications (heparin, chemo, pressors, narcotics...). In an inpatient or long term care environment the initial...

  18. Feeling like a failure in ER nursing

    PeakRN replied to ERnurseH's topic in Emergency

    I've worked in EDs that have great and less than ideal cultures. If a task is being performed safely and effectively then there isn't a need to scold someone for different techniques. I'm always...

  19. Transitioning to ER. Any tips?

    PeakRN replied to What?_ER?_Me?'s topic in Emergency

    In my experience most new hire ED nurses, especially those without EMS or intensive care backgrounds, are "too nice." If someone started out new and was already getting crispy I would wonder why they...

  20. LPNs in the ER

    PeakRN replied to amandab13's topic in Emergency

    We do not have LPNs in our ED. LPNs can not test for TNCC or ENPC and therefore cannot be certified per the ENA, but may audit the course. We don't have LPNs in any of our critical care environments...

  21. Chemo for hospitalized patients.

    PeakRN replied to YoBee's topic in Oncology

    Inpatient who are receiving chemotheraphy are either admitted to the oncology floor, BMT, ICU, Peds Onc, or PICU. There are nurses who have ONS chemo certification on ONC, BMT, and Peds Onc; all of...

  22. Peds/Neuro Advice

    PeakRN replied to Quinticx's topic in Pediatric

    If you are planning on pursuing PNP-AC with your DNP you will find a lot of difficulty getting a job without pediatric acute care experience. Keep in mind that many kids who are being treated for...

  23. Exploring the Gender Pay Gap in Nursing

    PeakRN replied to Melissa Mills's topic in General Nursing

    It's just how it is. We are a quaternary referral hosptial so our nurses get a lot of pride out of our care, and we pay more than the competing systems (on average) so there isn't a lot of motive to...

  24. What was orientation like for the ER?

    PeakRN replied to northmississippi's topic in Emergency

    Our new grad ED program includes 5 months of classroom and bedside orientation. Most of our education is focused on preparing new nurses to take an adult ED pod, but we have them spend time in...

  25. ACCN Emergency Dilemma

    PeakRN replied to mediwizard's topic in Emergency

    The Emergency Nurses Association has great education, and I would go to them before the AACN. AACN provides very good education but is geared towards ICU nurses rather than the ED. While the ED sees...